Individual
DOMINIC VINCENT HURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 W 12TH AVE STE 207, EMPORIA, KS 66801
(620) 342-4278
Mailing address
1201 W 12TH AVE, EMPORIA, KS 66801-2504
(620) 343-6800
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
1974
SD
207RC0000X
Cardiovascular Disease Physician
27785
IA
207RI0011X
Interventional Cardiology Physician
Primary
1974
SD
207RI0011X
Interventional Cardiology Physician
27785
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006095
BCBS
SD
01
—
060057374
RAILROAD MEDICARE
SD
01
—
060063694
RAILROAD MEDICARE
IA
01
—
07224
BCBS
IA
05
—
1955518
—
IA
01
—
19D71HU
BCBS
MN
05
—
546090500
—
MN
05
—
6001954
—
SD
Enumeration date
06/27/2005
Last updated
05/14/2019
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